Severe heart failure in the setting of relatively mild mitral stenosis: the role of invasive hemodynamic assessment.
For patients with heart failure and relatively mild mitral stenosis, an exercise hemodynamic study should be considered. However, exercise intolerance is a common symptom in a variety of cardiac and noncardiac diseases, emphasizing the need for a thorough differential diagnosis in the planning and execution of these studies. This manuscript discusses two cases that illustrate the need for this comprehensive approach, the indications for balloon mitral valvuloplasty, and the recognition of diastolic dysfunction in these patients.
Sorajja
Paul
P
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. paul.sorajja@mayo.edu
Borlaug
Barry A
BA
D000368:Aged; D006328:Cardiac Catheterization; D002404:Catheterization; D003937:Diagnosis, Differential; D004417:Dyspnea / Q000209:etiology / Q000503:physiopathology; D025401:Echocardiography, Stress; D017548:Echocardiography, Transesophageal; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D011237:Predictive Value of Tests; D012720:Severity of Illness Index